Surgical and interventional radiological management of adult epistaxis: Systematic review

C. Swords, A. Patel, M.E. Smith, R.J. Williams, I. Kuhn, C. Hopkins

    Research output: Contribution to journalArticlepeer-review

    13 Citations (Scopus)


    There is variation regarding the use of surgery and interventional radiological techniques in the management of epistaxis. This review evaluates the effectiveness of surgical artery ligation compared to direct treatments (nasal packing, cautery), and that of embolisation compared to direct treatments and surgery.

    A systematic review of the literature was performed using a standardised published methodology and custom database search strategy.

    Thirty-seven studies were identified relating to surgery, and 34 articles relating to interventional radiology. For patients with refractory epistaxis, endoscopic sphenopalatine artery ligation had the most favourable adverse effect profile and success rate compared to other forms of surgical artery ligation. Endoscopic sphenopalatine artery ligation and embolisation had similar success rates (73–100 per cent and 75–92 per cent, respectively), although embolisation was associated with more serious adverse effects (risk of stroke, 1.1–1.5 per cent). No articles directly compared the two techniques.

    Trials comparing endoscopic sphenopalatine artery ligation to embolisation are required to better evaluate the clinical and economic effects of intervention in epistaxis.
    Original languageEnglish
    Pages (from-to)1108-1130
    Number of pages23
    JournalJournal of Laryngology and Otology
    Issue number12
    Early online date27 Dec 2017
    Publication statusE-pub ahead of print - 27 Dec 2017


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